Tuesday, December 27, 2016

There were 120,688 newly reported cases of end-stage kidney disease, representing a slight increase of 1.1 percent compared to 2013. At the end of 2014, there were 678,383 dialysis and transplant patients receiving treatment for end-stage kidney disease, up 3.5 percent from 2013.

Among all patients who currently receive hemodialysis, use of an arteriovenous fistula, a surgically created vein used to remove and return blood during dialysis, since 2003, has increased from 32 percent to 63 percent. Arteriovenous catheter use has also declined from 27 percent to 18 percent during this period.

Medicare spending for beneficiaries ages 65 and older who have chronic kidney disease exceeded $50 billion, representing 20 percent of all Medicare spending in this age group. Total Medicare fee-for-service spending in the general Medicare population increased by 3.8 percent in 2014 to $435.6 billion, with $32.8 billion, or 7.2 percent, of that overall spending accounting for end-stage kidney disease patients. Compared to 2013, the costs of Part D claims and skilled nursing facility care in 2014 grew at the fastest rates of 21 percent and 5.5. percent, respectively.

Prior to 2013, Medicare spending on hospice care in end-stage kidney disease patients had been experiencing one of the highest rates of growth of any category of Medicare spending, but this spending declined by 6.3 percent in 2014.

As of December 31, 2014, the kidney transplant waiting list increased by 3 percent over the previous year to 88,231 candidates, of which 83 percent were awaiting their first kidney transplant. With less than 18,000 kidney transplants performed in 2014, the active waiting list was 2.8 times larger than the supply of donor kidneys.

“An interesting note on kidney transplants is a relatively recent initiative called kidney paired donation,” Saran says. “The initiative is aimed at increasing the availability of living donor transplants, and in its simplest form is essentially when two living donors do not match with the respective recipients and decide to perform an exchange whereby the donation goes to each other’s compatible recipient. Kidney paired donation transplants have risen sharply in recent years with 552 performed in 2014, representing 10 percent of living donor transplants that year.”